Asthma
Treatment and Management
Management of asthma
Asthma treatment aims to help patients to lead a normal, active and symptom-free life.1 Inhaled steroid and bronchodilators are the cornerstone of asthma management, designed to deliver an effective amount of medication directly into the lungs with minimal systemic effects.1-3 However, pharmacological management should be part of an overall treatment plan that considers patients’ wellbeing and includes:2-4
- Smoking cessation therapy: With smoking cessation support
- Influenza vaccination: Which should be offered annually
- Weight-loss interventions: For overweight or obese patients
- Healthy lifestyle: Including consumption of a healthy diet and physical activity
- Self-management education: Including a personalized asthma action plan
- Breathing exercise programs: To help improve quality of life
- Managing comorbidities: Considering concomitant medications and encouraging avoidance of those that may exacerbate asthma
Considering concomitant medications and encouraging avoidance of those that may exacerbate asthma
Why inhaler technique matters
Correct inhaler technique and adherence to therapy is key to achieving better asthma control and improving quality of life.4,5 There are several types of inhalers available, which utilize varying inhalation techniques.1
| Inhaler* | Inhalation technique* |
|---|---|
| Dry powder inhalers (DPIs)1 | QUICK and DEEP2 |
| Pressurized metered-dose inhalers (pMDIs)1 | SLOW and STEADY1 |
| Soft-mist inhalers (SMIs)6 | SLOW and STEADY6 |
*Different inhalers may have different instructions. Please refer to specific device SPC before use.
Up to 70−80% of patients with asthma have sub-optimal inhaler technique and may be unaware they have a problem.4 An incorrect technique can lead to poor asthma control, increased risk of exacerbations and increased adverse effects, so it’s important to ensure that your patient receives adequate training on how to use their inhaler correctly:4
- Choose the most appropriate inhaler before prescribing – if there are multiple options, involve the patient in making the choice4
- Demonstrate how to use the inhaler4
- Inhalers should only be prescribed after patients have demonstrated satisfactory technique4
- At each review or visit, monitor adherence, check inhaler technique and correct if necessary4
References:
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Murphy A. Pharm J 2016;297(7891).
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NICE guideline [NG80]. Asthma: diagnosis, monitoring and chronic asthma management, 2017. www.nice.org.uk/guidance/ng80. Accessed 03 May 2021.
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BTS/SIGN. British guideline on the management of asthma, 2019. www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/. Accessed 03 May 2021.
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Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (GINA) 2020.
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Usmani OS et al. Ther Clin Risk Manag 2019; 15: 461–472.
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Guidelines in practice. Inhaler choice guideline. https://www.guidelines.co.uk/respiratory/inhaler-choice-guideline/252870.article. Accessed 03 May 2021.